First, the illustrations that accompany the text are great. The illustrator, Jonathan Powell, manages to capture the confusion that comes along with the whirlwind of changes youngsters experience while going through puberty. I had a good chuckle over a few of them because I remember feeling that confused when growing up and I’ve seen those looks on people’s faces in real life.

Attwood presents information for parent and child alike in simple but accurate terms allowing for the straightforward communication of information that helps to minimize anxiety generally associated with these aspects of growing up. Parents and youngsters both get a clear idea of what’s going and with this knowledge both are able to prepare for the changes of growing up.

This next section alone sold me on the book and prompted me to write this review. Attwood’s insight into how the mind of a youngster works is apparent in her discussion of how and why they have to begin bathing daily. She is very clear, you’ve got to bathe every day and it is not enough to get in the shower and stand there getting wet. You have to use soap. How many times have I had this same conversation with my own children! Attwood explains the process of daily bathing, focusing on specific areas of the body and explaining why those areas need special attention with soap. The fact that she recognizes the need to be this explicit about something as seemingly simple as bathing indicates that Attwood knows her audience well.

Finally Attwood addresses issues of sexuality with a neutral tone that allows parents to bring their own values and moral convictions to the conversation without having to work around anyone else’s agenda on the matter. Such sensitivity can be appreciated by a wide range of people  making the book a useful tool for pretty much anyone who is looking to prepare themselves and the youngsters in their lives for the rollercoaster ride of puberty into adulthood.

DSM V proposed revisions

I will probably be taking an unpopular position. However, I want to calm some people who are legitimately upset as they are concerned about the well-being of their children, and the children of others, regarding the changes in the DSM-V as they pertain to autism. I do not see anyone getting undiagnosed. I do not see anyone getting services loosing those services. Hopefully I can sufficiently explain this to calm people.

There is a critical flaw in the study the NY Times article relied on. They were using 1993 data for the study. In 1993 there was only the DSM-III. Asperger's and PDD-NOS were not even in the DSM. So much more has been learned about autism in the last 19 years using such old data is absurd. 19 years ago they still were not too sure what they were looking for. This would have a huge impact on the data gathered. I am guessing it was all there, but the people recording data didn't know to look for it and therefore could not record it.

As someone who is around autism all day every day, and does diagnostic work, I don't think there needs to be fear about the proposed changes to the DSM coming out in 2013. I need to stay on top of all this, and intimately understand all the details and nuances. It is my job. I work with the DSM-IV and I am also familiar with the expected changes in the DSM-V. The proposed changes came out 2 years ago, and were last tweaked a year ago. The only recent change that ignited a firestorm was there was an article in the NY Times January 19, 2012.

Autism, Asperger's, and PDD-NOS are all really the same thing. With recognizing that, and understanding it in an everyday clinical sense from professionals, the APA is combining the three into one diagnosis of "Autism Spectrum Disorder". This makes complete and total sense, and I support it 100%. The only question then is does the new diagnostic criteria make sense and work.

Part of the problem is that a lot of people do not understand the criteria as they are now, including a lot of professionals. The autism spectrum is not a scale of mild to severe, with the diagnosis you receive depending on the severity of symptoms. Spectrum represents a diversity in individual manifestation of symptoms.

By Samantha Pierce

Is Asperger's Overdiagnosed?

Recently the above question, posed and supposedly answered in the affirmative in a pair of New York Times opinion editorials, has been making the rounds in public discourse. It is interesting that as awareness of autism spectrum disorders begins to rise the response of the public seems to be that autism spectrum disorders, of which Asperger's is one, are over diagnosed. I would love to see some research to back up such claims. Anecdotes do not equal data as the saying goes. 

I think this represents a spilling over of a long standing conflict within the autism community. If you spend enough time in any autism related forum you will eventually find two different camps of opinion. There are those who divide the autistic community into the "real" autistics, those who are easily identified as having some sort of impairment (often non-verbal), and the "fake" autistics, those who are able to communicate with the neurotypical world (i.e. they can talk or at least write like they can talk). Then there are those who recognize that the "real" and "fake" autistics fall under the same umbrella if one is willing to take a careful look at how they experience the world.

Personally I have children who fall into both of these categories and I see this conflict as a harmful distraction for the autistic community. As different as my children may appear to be to the outside world, upon close examination they have many traits in common.

Now that the unsubstantiated claims that there are "real" and "fake" autistic people have hit the mainstream we are beginning to see why this conflict is so harmful in the first place. These unsubstantiated claims of over diagnosis are now being used to marginalize people that many have been fighting to bring into the mainstream.

Research into the matter indicates that autism spectrum disorders are likely under diagnosed. Anyone claiming otherwise needs to bring data to the table for rigorous evaluation.